Chest infection management

Keep her tucked up in bed until her symptoms have resolved?

Secretions need to be mobilised to assist with removal and having your patient mobile or at least nursed in an upright position, with frequent changes of position will best facilitate this.

Monitor Mrs McGinty’s oxygen levels regularly?

Because of Mrs McGinty’s previous history of COPD the most accurate way of monitoring her O₂ levels may be via obtaining at least one set of Arterial Blood Gases. Ongoing objective assessment of her symptoms and measurement of O₂ saturations via finger/ear probe would also be recommended.

Give high levels of oxygen to ensure adequate oxygen saturation levels?

Given Mrs McGinty’s existing COPD high levels of oxygen may actually exacerbate her condition. Clarification of her COPD type/diagnosis via her casenotes would be beneficial.

Refer to the physiotherapist?

This will assist Mrs McGinty to cope with removal of any excess secretions. Her normal cough/method of expectoration may be limited by her muscle weakness and the physiotherapist will be able to assist and advise regarding positioning and facilitation of expectoration. It is recommended that Mrs McGinty is nursed in an upright position to maximise her ventilation.

Refer Mrs McGinty for an assessment or review of her swallowing?

It may be beneficial to have Mrs McGinty’s swallowing reviewed to ensure the chest infection is not due to ongoing aspiration issues.

Check if Mrs McGinty is dehydrated?

Dehydration can make secretions increasingly thick and difficult to clear. She may require additional fluids systemically and if on oxygen this may need to be humidified. Nebulised saline or bronchodilators may also be prescribed. Regular oral care is required as nil-by-mouth and oxygen therapy have a drying effect on oral mucosa.